کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5675992 1594883 2016 14 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Hospital delivery volume, severe obstetrical morbidity, and failure to rescue
ترجمه فارسی عنوان
حجم تحویل بیمارستان، بیماری های شدید مامایی، و ناتوانی در نجات
کلمات کلیدی
شکست نجات، حجم تحویل بیمارستان، شدید بیماری مادری،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
چکیده انگلیسی

BackgroundIn the setting of persistently high risk for maternal death and severe obstetric morbidity, little is known about the relationship between hospital delivery volume and maternal outcomes.ObjectiveThe objectives of this analysis were (1) to determine maternal risk for severe morbidity during delivery hospitalizations by hospital delivery volume in the United States and (2) to characterize, by hospital volume, the risk for death in the setting of severe obstetric morbidity, a concept known as failure to rescue.Study DesignThis cohort study evaluated 50,433,539 delivery hospitalizations across the United States from 1998-2010. The main outcome measures were (1) severe morbidity that was defined as a composite of any 1 of 15 diagnoses that are representative of acute organ injury and critical illness and (2) failure to rescue that was defined as death in the setting of severe morbidity.ResultsThe prevalence of severe morbidity rose from 471.2-751.5 cases per 100,000 deliveries from 1998-2010, which was an increase of 59.5%. Failure to rescue was highest in 1998 (1.5%), decreased to 0.6% in 2007, and rose to 0.9% in 2010. In models that were adjusted for comorbid risk and hospital factors, both low and high annualized delivery volume were associated with increased risk for failure to rescue and severe morbidity. However, the relative importance of hospital volume for both outcomes compared with other factors was relatively small.ConclusionAlthough low-and high-delivery volume are associated with increased risk for both failure to rescue and severe maternal morbidity, other factors, in particular characteristics of individual centers, may be more important in the determination of outcomes.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: American Journal of Obstetrics and Gynecology - Volume 215, Issue 6, December 2016, Pages 795.e1-795.e14
نویسندگان
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